Functional Decline, Hospitalization-associated Disability, Iatrogenic Disease
Conditions
Keywords
Aged, Frail, Functional decline, Impairment, valvular heart disease, Cohort, risk factors
Brief summary
This prospective cohort study aims to determine the incidence of hospitalization-associated disability and its association with risk factors at the patient level and with care and hospital processes. For this, patients aged 70 years or older admitted for elective valve surgery or elective transcatheter aortic valve implantation or as a result of symptomatic moderate to severe valvular heart disease will be consecutively included from 01 October 2015 to 29 February 2016.
Interventions
PROCEDURENot applicable (observational design)
Sponsors
KU Leuven
Universitaire Ziekenhuizen KU Leuven
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Aged 70 years or older * Admitted for elective heart valve surgery (replacement, repair or combined with CABG) or if admitted for elective transcatheter aortic valve implantation, or if a patient presents with symptomatic moderate to severe valvular heart disease on hospital admission as evidenced by moderate to severe valve regurgitation (≥ 2/4) or aortic valve area ≤ 1cm2 or mitral valve area ≤ 1.5cm2 and if one of the following symptoms is present: heart failure, decreased exercise tolerance, (exertional) dyspnea, (exertional) angina, (exertional) syncope * Dutch speaking
Exclusion criteria
* Life expectancy less than 6 months * Expected length of stay less than 48 hours
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hospitalization-associated Disability | Up to 30 days post-hospital discharge | The loss of ability to complete one of the basic ADLs independently between baseline and hospital discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Five meter gait speed test | Up to 30 days post-hospital discharge | — |
| Timed get-up and go test | Up to 30 days post-hospital discharge | — |
| The six minutes walking distance test | Up to 30 days post-hospital discharge | — |
| Peak handgrip force assessed at the dominant side with the elbow at 90° of flexion, and the forearm and wrist in a neutral position. | Up to 30 days post-hospital discharge | Isometric handgrip force will be measured with a hydraulic hand dynamometer (Jamar dynamometer; JA Preston Corporation; Jackson, MI) |
| Inappropriate medication prescribing | Up to 30 days post-hospital discharge | Inappropriate medication prescribing using the RASP-list (Rationalization of Home Medication by an Adjusted STOPP list in Older Patients) |
| Peak extension torque measured at the right side and evaluated at 60° of knee flexion | Up to 30 days post-hospital discharge | Isometric quadriceps strength will be measured using a dynamometer (Biodex system 4 pro; Enraf Nonius; Delft, The Netherlands) |
Countries
Belgium
Outcome results
None listed